Non-linear projections of 3-d medical imaging data

ABSTRACT

The present invention improves projection displays of volume data. Using the Minimum Intensity Projection (MinIP), fluid filled regions or other regions of hyporeflective tissue are displayed. By limiting the projection to partial volumes within the volume, differences in the scattering intensity within specific regions are isolated. In this way, hyperreflectivity of weakly scattering tissue can be assessed.

PRIORITY CLAIM

This is a continuation of U.S. patent application Ser. No. 13/692,781,filed Dec. 3, 2012 which is in turn a continuation of U.S. patentapplication Ser. No. 12/535,046, filed Aug. 4, 2009 the disclosures ofwhich are incorporated herein by reference.

TECHNICAL FIELD

The present invention relates to non-linear projections of 3-D medicalimaging data, and in particular to optical medical imaging such asOptical Coherence Tomography (“OCT”) for use in diagnosis and monitoringof tissue health.

BACKGROUND

Volume imaging data has become prevalent in medical imaging modalitiessuch as ultrasound imaging, magnetic resonance imaging, computedtomography, and Optical Coherence Tomography (OCT). Volume data hasbrought innovation to the medical field, making it possible to safelyand noninvasively directly observe the internal structure of a body, inparticular of a human body. In recent years, volume rendering imageprocessing techniques have been used to reduce the volume data to imagesdisplayed for medical diagnosis. Volume rendering enables visualizationof three-dimensional structures by displaying a 2D projection of the 3Dstructure on commercially available 2D display.

Optical Coherence Tomography (OCT) is a technology for performinghigh-resolution real time optical imaging in situ. OCT is an opticalmeasurement and imaging technique using either low-coherent light from abroadband source or sweeping light from a tunable laser to createinterference signals measuring backscatter intensity at depths along asample path. This depth profile is commonly called an “A-scan”.Laterally scanning the sample beam over a series of adjacent A-scanssynthesizes cross-sectional images, creating a 2-D tomogram commonlycalled a B-scan. Typically, volumes are acquired by laterally scanningthe sample beam over a series of B-scans; however alternative scanpatterns, such as a spiral scan pattern, have been suggested to acquirevolume data.

Evaluation of biological materials using OCT was first disclosed in theearly 1990's (see U.S. Pat. No. 5,321,501, Swanson, et al.). Morerecently it has been demonstrated that frequency domain OCT (FD-OCT) hassignificant advantages in speed and signal to noise ratio compared totime domain OCT (Leitgeb, R. A., et al., (2003) Optics Express11:889-894). In Spectral Domain OCT (SD-OCT), sometimes referred to asFrequency Domain OCT (FD-OCT) and sometimes also referred to as SpectralRadar (Häusler, G and Linder, M W, Journal of Biomedical Optics Vol. 3No. 1 (1998) 21-31), the measurement is achieved by examining thespectral content of the interference pattern out of the interferometer.

Volume data is reduced from 3-D to 2-D for display on a monitor or whenprinted on paper. In U.S. Pat. No. 7,301,644, Knighton et al. discloseda method for reducing 3-D data for 2-D display called en-face imaging.This technique takes the volume data (or an interesting volume subset ofthe 3-D dataset) and integrates the data along each A-line, creating a2-D image from the 3-D dataset. This technique has proven to be a veryuseful tool for viewing the OCT volume data. In light of the above,there is a need in the art for additional methods for viewing 2-D imagesof 3-D volume OCT data. The present invention provides such additionalmethods for creating 2-D images from 3-D volume data sets to displaymedically relevant information.

SUMMARY

The present invention is defined by the claims and nothing in thissection should be taken as a limitation on those claims. Advantageously,embodiments of the present invention provide additional means forobtaining and displaying medically relevant information extracted fromvolume data.

In accordance with one aspect of the present invention, a MinimumIntensity Projection (MinIP) is used to find a fluid filled region orregion of retinal disruption within a volume of data.

In accordance with another aspect of the present invention, volumeinformation has low-intensity speckle artifacts reduced prior toprojection through a partial volume.

In accordance with yet another aspect of the present invention, theprojection information is compensated for variations in illuminationprior to display.

In accordance with yet another aspect of the present invention, theMinIP is found along a collection of A-lines and the coordinatelocations of the minimal intensity points are stored. These locationsare smoothed before the smoothed locations are displayed as a minimumintensity height map.

In accordance with yet another aspect of the present invention, thepartial volume over which the MinIP is computed is determined at leastpartially as a function of at least one special location. The speciallocation may be user defined, or automatically computed from the volumeimage data.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic illustration of a MinIP display using the partialvolume between the ILM and the RPE.

FIG. 2 is a schematic illustration of a MinIP display using the partialvolume between the OPL and the RPE.

FIG. 3 is a flowchart of an embodied MinIP display application.

FIG. 4 is a flowchart of an embodied display application in which thelocation of the minimum intensity is used to determine a surface fromwhich the displayed intensity is determined.

FIG. 5 is an image showing hyperreflective tissue.

FIG. 6 is an image showing both hyperreflective and hyporeflectivetissue.

FIG. 7 illustrates one design of an optical coherence tomography system.

DETAILED DESCRIPTION

The embodiments expressed herein are examples and the descriptionspresented have been chosen to illustrate the principles of the inventionand its practical applications and not as a definition of the invention.Modifications and variations of the invention will be apparent to thoseskilled in the art. The scope of the invention is defined by the claims,which includes known equivalents and unforeseeable equivalents at thetime of filing of this application.

Herein, an intensity projection of an image volume is a two dimensionalintensity image derived from the image volume by casting projection raysthrough the volume and determining a single intensity to represent eachray. A maximum intensity projection (MIP) is created by firstidentifying the pixel in each ray that has the highest intensity. Animage is then created by mapping the locations of the rays to locationsin the image and setting the intensity of the pixel at each location tothe highest intensity associated with that ray. Similarly, a minimumintensity projection (MinIP) is the intensity projection with the resultchosen to be the minimum intensity along the ray. In general MIP andMinIP can be formed casting projection rays along the x-, y-, or z-axis,or in any direction whatsoever. In MIP, each selected point has theattribute that its intensity is greater than or equal to the intensityof any other point along the projection ray. Similarly, MinIP selectspoints according to the minimum attribute. Many other attributes may beascribed to some point along the projection array. For example, thelocation nearest the upper surface of the volume through which theprojection ray is cast with intensity equal to the median intensityalong the projection ray provides another attribute by which a singleimage point may be selected for each projection ray. The maximum,minimum, and median are nonlinear functionals—they do not satisfy theadditivity property of linear functionals. In contrast, summation andintegration are linear functionals. For simplicity of exposition, MinIPwill be the primary example used throughout this description and rayswill normally be cast parallel to the z-axis.

In an imaging modality where a fluid filled region is less reflectivethan the surrounding tissue, the minimum intensity projection (MinIP)offers a unique display technique. The MinIP provides a 2-D projectionof the boundary of the fluid filled region. In the early 1990s, minimumintensity projections were used in Nuclear Magnetic Resonance Imaging tofind fluid filled regions (U.S. Pat. No. 5,189,369, Takane et al.).Ophthalmologic images present a unique challenge, since the eye itselfis fluid filled and OCT images contain speckle, which is an interferencepattern in the backscattered light that causes intensity variations inthe image. Speckle can create a very low intensity reflection in themidst of highly reflective tissue. By the late 90's, systems forray-casting projections through speckle reduced ultrasound volumes weredisclosed (U.S. Pat. No. 5,779,641, Hatfield, et al.) Speckle can bereduced by spatial or frequency compounding, low pass filtering imagedata, or other means. These systems, however, fail to recognize theimportance of casting the projection through a partial volume (i.e.,through a limited volume region.)

In OCT, the preferred method for visualizing fluid has been to measurethe overall macular thickness. This method may delineate pockets offluid, but it does so imprecisely. The invention disclosed herein, usingMinIP, is sensitive to extremely small pockets of fluid. In prior artefforts, automatic segmentation of fluid pockets was difficult toperform reliably, and manual intervention to correct errors in automaticsegmentation is time consuming and operator dependent. While theembodiments enclosed herein do not provide volume information, theyenable the visualization of fluid filled regions, which is mostimportant for determining drug treatment. For laser treatment, knowingthe lateral location and extent of fluid lesions is critical forprecisely targeting treatment where it is needed.

The Minimum Intensity Projection (MinIP) is a projection algorithm thatfinds the minimum brightness along the projection path in a volume ofdata. MinIP solves the problem of viewing the volume image when lookingfor weak reflections or deep shadows. For imaging systems that imagebackscattered radiation, i.e., imaging systems like OCT, hyporeflectiveregions surrounded by more reflective regions are readily detectable.Not all anatomy of interest is strongly reflecting. Often anatomy ofinterest, such as hyporeflective pockets of fluid within the retina areweakly reflecting. Such anatomy may be best visualized using minimumintensity projections.

The Outer Nuclear Layer (ONL) is normally not as reflective as otherretinal tissue. Tissue that backscatters more light than normal ishyperreflective. In converse, tissue that backscatters less light thannormal is hyporeflective. Even in the presence of diseased or disruptedretina which may cause hyperreflectivity in the ONL, the ONL oftenremains less reflective than neighboring retinal tissue. Thus, even ahyperreflective ONL may be the least reflective tissue found along aprojection line and thus the hyperreflective ONL will still appear inthe MinIP, but it will be brighter than normal. Hyperreflectivity in theOuter Nuclear Layer and other normally dark regions of the retina alsocan appear over and around areas of retinal disruption.

As with most modern image processing procedures, the preferred MinIPimplementation is by means of an electronic computational processingunit or CPU. The CPU might be a general purpose computer like a PC orworkstation or a specialized CPU such as a digital signal processor(DSP), application specific integrated circuit (ASIC), fieldprogrammable gate array (FPGA) or any other integrated circuit, whetherfully contained in a single package or distributed across multiplechips.

In one embodiment of the invention, an OCT image volume and twosegmented surfaces of the retina (e.g., ILM and RPE, or ILM and IS/OS)are required. The two segmented surfaces bound the partial volumethrough which the minimum projection is cast. The choice of surfaces maysignificantly impact the resulting MinIP display. The data depicted inFIG. 1 illustrates an example where the MinIP 160 is generated from thepartial volume between the inner limiting membrane (ILM) 110 and theretinal pigment epithelium (RPE) 150. The illustrated strip 160representing the MinIP has been widened for illustrative purposes. Theprojection cast along a ray is a single point or pixel. The wider banddepicted here makes the MinIP intensity values easier to see.

For the example data depicted in FIG. 1, the MinIP 160 is the samewhether it is generated from the partial volume between the ILM 110 andthe RPE 160 or it is generated from the partial volume between the ILMand the boundary between the inner segment and outer segments ofphotoreceptors (IS/OS) 140. This is because the intensity depicted forthe IS/OS is greater than the intensities depicted for neighboringtissue on either side of the IS/OS. Hence, the IS/OS intensity will notbe the selected minimum. Furthermore, the depicted data has theintensity of the scattering tissue between the IS/OS and the RPE that isno less than the tissue above the IS/OS. Hence, the data from the IS/OSto the RPE in this example, do not change the intensity of the minimumintensity along the projection ray. This data was chosen forillustrative purposes and in no way implies that backscatter returnedfrom below the IS/OS cannot have intensities less than the intensitiesderived from backscatter above the IS/OS. It can, but in this example,does not.

FIG. 2 illustrates how the MinIP can change by changing the partialvolume through which the projection ray is cast. FIG. 2 illustrates thesame theoretical eye as FIG. 1. That is, the data illustrated in FIGS. 1and 2 are the same. However, the MinIP 260 is generated from the partialvolume between the outer plexiform layer (OPL) 230 and the RPE 250whereas the MinIP 160 in FIG. 1 was generated from the partial volumebetween the ILM 110 and the RPE 150. The fluid filled region 235 iswithin the outer nuclear layer (ONL) 240. Because the MinIP in thisexample was cast between the OPL and the RPE, the fluid filled region235 is readily apparent in the MinIP strip 260. However, thehyporeflective regions 225, which appeared in MinIP strip 160 are notvisible in the MinIP strip 260 because they are not within the partialvolume used to generate the display.

In an alternate embodiment of the invention, an OCT image volume and onesegmentation of the retina (e.g., ILM, RPE, ILM, or IS/OS) is required.In this case, the segmented surface and a predefined or computedparameter or surface can define the partial volume through which theminimum projection is performed. The volume could be all points within agiven distance of the surface; or it could be all points within a fixeddepth below (or above) the surface, or all points within a range from afixed offset to the surface, or other volume defined with respect to thesurface. Alternatively, a surface can be defined by fitting a smoothsurface to the segmented surface. The volume can be defined as the spacebetween the surfaces or the space between a surface offset a fixeddistance from the segmented surface to a surface offset a fixed distancefrom the computed surface, or other volume defined with respect to thetwo surfaces. In yet another embodiment of the invention, an imagevolume and an a priori defined subset of the volume are required. Inthis case, the partial volume through which the minimum projection isperformed is chosen to be the a priori defined subset of the completeimage volume.

FIG. 3 is a flowchart of an embodied MinIP display application. A volumedata 310 is input into the application. A partial volume is selected orchosen 320, either by one of the methods described above or by someother means for choosing a subvolume of the actual volume. The speckleis reduced in the partial volume 330, in one embodiment by a smoothingfilter that is preferably larger than a speckle cell and smaller thanthe body to be imaged, or in other embodiments, by other imageprocessing means. Rays are cast 340 through the partial volume and thelocation and intensity of the minimal intensity along each ray aredetermined 350. An image is formed from the minimal intensities and thatimage is displayed 360. The displayed image can be comprised of theminimum intensity values, or normalized minimum intensity values thatare compensated for variations in illumination. The intensities withinthe ray are affected by what the light has passed through beforeentering the partial volume. Hence, when rays are cast in the directionof the illumination light (along the z-axis), a local compensation maybe applied to the projection ray before computing the minimum, or, inparticular if the compensation is linear, simply applied to the minimumselected from the ray. For example, the displayed values can be minimumintensity values normalized by the mean intensity along the projectionray within the partial volume. This normalization factor may be computedfrom points within the partial volume that are within a localneighborhood of the projection ray, or even points within the entirevolume that are within a local neighborhood of the projection ray.Additionally, the display pixels can be smoothed to present a moreappealing image. This is perhaps the simplest embodiment of theinvention disclosed herein.

Minimum intensity projections determined according by the process of thepreceding paragraph can have an “unnatural” look, in part because thedepths from which the intensity displayed in the image is taken can behighly irregular, jumping greatly in depth even over small changes inX-Y. While determining the minimum intensity, we can save and then usethe location within the image volume from which the minimum intensitywas attained. We denote the depth at which the minimal intensity isattained by z_(min)(x,y). That is, z_(min)(x,y) is the depth of thelocation of the minimal intensity to be displayed at the (x,y) pixel ofthe MinIP image. We can improve the visual impression of the displayedimage and get a more natural looking en-face image by fitting a smoothsurface to the collection of points (x, y, z_(min)(x,y)) and thenintegrating the volume image intensities a certain margin above andbelow a smoothed surface. A two-dimensional quadratic or quartic surfacegenerally gives a sufficiently smooth contour, although in some casesthe fitting may not follow the desired anatomy because it is too smoothor the areas of abnormal anatomy were not properly excluded from thefitting. Technically, the en-face image generated by integrating in theneighborhood of a smoothly fit surface is no longer a minimal intensityprojection display image. It does, however, require finding the minimalintensity projection voxels in order to compute the displayed image. Inthe limit where the en-face is only over a single pixel, the intensityvalues on the smooth surface are displayed.

Alternatively, the visual impression of the displayed image will appearmore natural if the locations of the depths z_(min)(x,y) are constrainedto be within a local neighborhood. For example, the smoothed surfacefitted to the collection of points (x, y, z_(min)(x,y)) can be used todefine a new partial volume and the MinIP can be recomputed over thisvolume. Alternatively, it can be accomplished by first choosing acollection of MinIP points as good and recomputing the remaining pointsby constraining the search for the minimum intensity point at aneighboring location further within the partial volume so thatneighboring MinIP is chosen from a set of points within a fixed distanceof the location of the chosen neighbor.

In yet another alternative, an intensity other than the minimumintensity along the projection ray can be chosen. Grayscale image dataintensities are distributed according to a Gaussian-like distribution inthat the number of voxels with intensities near the mean is far greaterthan the number of voxels with intensities in the tails of thedistribution. The minimum values of the image data along the rays insome regions will fluctuate statistically from ray to ray since theminima occur out in the sparsely populated tail of the intensitydistribution. Selecting an intensity level slightly higher than theminimum, such as the 5th-percentile intensity, selects a portion of theintensity distribution that is more highly populated and thus lesssusceptible to statistical fluctuation, yet it preserves most of thecharacteristics of the minimum. Thus choosing the 5th percentileintensity value along the projection ray produces a smoother, less noisyimage than the minimum intensity projection, although it may fail todepict fluid in locations where the total height of fluid-filled regionsis less than 5% of the retinal thickness.

FIG. 4 depicts an alternative embodiment of the disclosed invention. Thevolume data is acquired 410 and a partial volume is selected 420. Thespeckle in the data is reduced 430 before rays are cast 440 and thelocation and intensity of the minimum intensity along the cast ray isdetermined 450. In this embodiment, the display intensities areindirectly determined from minimum values along the cast rays, so onlythose rays that are needed to implement the method are cast 460. In mostcases, the more rays cast up to the resolution of the image volume, thebetter and more accurate the final display will be. The locations wherethe minimum intensities along the cast rays were found are points withinthe partial volume. A surface is determined from these locations 470.This surface may be the collection of location points themselves, or itmay be a surface fit to those locations, or any surface otherwisedetermined from the location of the minimum intensity points. A smoothsurface is determined 480 either directly from the points so that thesmoothed surface of 480 is the same as the surface of 470, or the smoothsurface is determined from the surface of 470. This smooth surfaceshould be within the volume. The intensity of image pixels within thevolume are used to determine intensities at locations on the smoothsurface 490 and the intensities on the smooth are used to create animage for display 495. As in the previous example, the displayed imagecan be comprised of the computed intensity values, or normalizedcomputed intensity values that are compensated for variations inillumination. Additionally, the display pixels can be smoothed topresent a more appealing image.

Alternatively, the locations of the minimum intensity pixels can be usedto create a minimum intensity height map. That is, a map of the heightof the minimum intensity locations can be determined. When theprojection ray is cast parallel to the Z-axis, the height is just thelocation along the ray (or a constant offset from that location,depending on the origin from which the height is calculated). If theprojection ray is not parallel to the Z-axis, but is rather at an angleθ to the Z-axis, then the actual height is proportional to the locationof the minimal intensity along the ray for the appropriate choice oforigin. The proportionality is constant for all rays. The minimumintensity height map can be displayed as a surface rendered from a 3-Dvolume or as a 2-D image, with the height encoded by color orbrightness. This height may be usefully displayed relative to thelocation of the RPE or some other segmented or fitted surface from theimage volume.

In light of FIG. 4, instead of the locations of minimum intensity alongthe projection ray depicted in 470, we can choose the location along theprojection ray where the intensity attains, for example, the 5^(th)percentile value. We can take the locations where these values wereattained and use them (instead of the minimum locations) to determinethe surface of 470. Of course, statistically as we move closer to the50th percentile, the likelihood of finding more than one location withthe same intensity increases. In this case, when implementing methodsfollowing the style of FIG. 4, a choice must be made, choosing one ofthe locations. This choice can simply be the first such point found,with the obvious bias attached, or we can choose locations based on thenearness of local clustering. Other means of choosing one location fromthe collection of locations will be obvious to those versed in the art.

Many forms of acquired image data contain an image artifact calledspeckle. Image speckle is a phenomenon generally associated with waveimaging and occurs as a result of wave interference at the detector. OCTand ultrasound image data (either 2-D or volume) generally containspeckle. The interference of various waveforms causes fluctuations ofthe detected intensity within the image volume. Volume image data withspeckle should have at least a mild speckle reduction process performedto reduce the null intensities created in the neighborhood of highintensity reflections before performing a minimum intensity projection.Mild speckle reduction is preferred because it is generally sufficientto remove deep nulls in the neighborhood of strong reflections andstronger speckle reduction techniques generally require more data, takelonger, and/or smear the data. Generally averaging across twice thespeckle diameter is sufficient. After speckle reduction, each axial scanis analyzed for the minimum intensity, i.e., the darkest gray level,between the segmentation boundaries or through the partial volume.

Alternatively, a projection through the partial volume in a directiondifferent from the axial scan direction can be performed. This generallyrequires interpolation and incurs inefficiencies in computational speed.Hence, projection along the axial direction is preferred.

As discussed previously, one approach to removing the “unnatural” lookof the MinIP display is to integrate an en-face about a smooth surfacederived from the collection of locations where the minimum intensitieswere attained. Another alternative for removing this “unnatural” look ofthe display is to globally define the minimum. That is, we can define ametric over a collection of intensity projections and choose theintensity projection of minimal intensity to display.

For example, if z_(ILM)(x,y) represents the ILM segmentation andz_(RPE)(x,y) represents the RPE segmentation, then a family of surfacesbetween the ILM and RPE is represented by:

z _(mix)(f,x,y)=f*z _(ILM)(x,y)+(1−f)*z_(RPE)(x,y)

where f is a desired fraction between 0 and 1, chosen to produce a darkimage generally falling in the ONL. For example, a set of images forf=0.1, 0.2, . . . , 0.9 can be generated and the image with the minimummedian intensity can be selected.

Any family of surface projections of the volume can be chosen whereby ametric can be applied by which a minimum surface can be chosen. Themetric can be the median intensity of a projection or the averageintensity of a surface or the absolute minimum intensity of a surface orany other metric. The metrics of the family of projections are comparedand that projection with the minimum metric is chosen for display. Ifmore than one surface has the same minimal value as its metric, a systemfor choosing one of these must be chosen. We can choose the first onewith the minimum value or the last one with the minimum value.Alternatively, the choices can be displayed and one can be chosen by anoperator. Alternatively, when the family is parameterized, the surfacewith parameter closest to a fixed value may be chosen.

Whether we smooth the collection of locations where the minimalintensity is found and integrate an en-face about that smoothed surface,or we fit a smooth surface to the collection of locations where theminimal intensity is found and integrate an en-face about that smoothsurface, or we choose a collection of smooth surfaces and find theminimum amongst them, the projection provides an image that is like aMinIP but has less discontinuity from changing depths of the displayeddata. They will be different from the MinIP, though, in that they maynot depict small pockets of fluid or other small dark areas because ofthe constraints on the smoothness of the imaged surface.

The Outer Nuclear Layer (ONL) 240 has had little attention paid to it inOCT research, in part because it is difficult to segment. The minimumintensity in the healthy macula usually lies within this layer. The ONLis significantly more reflective where retinal disruptions occur, e.g.,in the vicinity of retinal fluid pockets or over sub-RPE fluid.Longitudinal clinical studies may show whether this hyperreflectivitypredicts future locations of pathology. The axial location of theminimum intensity relative to the RPE may also indicate focaldisruptions in the retina, with increased height indicatinghyperreflectivity in the outer retina.

Some of the interesting information in Minimum Intensity Projections(MinIPs) comes from looking at the hyperreflectivity of the ONL that canbe caused by disruption of the retina. For this type of imaging, thepartial volume through which the minimum intensity is projected mustcontain the ONL. The minimum intensity lies in the ONL about 99% of thetime in healthy areas of the retina. If we do not have a good reliableONL segmentation, MinIPs are an alternative way to examine thehyperreflectivity of the ONL (although bright regions in a MinIP canalso mean the ONL has atrophied away completely). To ensure that you arelooking at the ONL, it is best to limit the partial volume to the regionbetween the OPL surface and the IS/OS surface. Since the IS/OS maysometimes be absent or invisible in the OCT images, limiting the partialvolume between the OPL and RPE is more reliable. Even the OPL isdifficult to segment and the results remain interesting when the partialvolume is taken between the ILM and the RPE. Alternatively, the partialvolume can be taken to be a volume above the RPE to a fixed distanceabove the RPE or the volume above the RPE to a surface that is apercentage of the distance from the RPE to the ILM. These partialvolumes can generally be used to incorporate a large portion if not allof the ONL. Though the partial volume may contain other tissue, thesurrounding tissue is generally brighter and thus will only appear inthe MinIP when the ONL is severely disrupted and is even morehyperreflective than the MinIP indicates at that point.

FIG. 5 is a MinIP image using a partial volume taken between the ILM andthe RPE and containing hyperreflective tissue in the ONL. An area ofhyperreflectivity is found within the circle 510. This region isdetermined to be hyperreflective because the average intensity withinthe region 510 is significantly higher than the average intensity of anormal region 520. Hyperreflectivity can be determined using statisticsother than the mean, such as the median. Any statistic which provides astatistically meaningful distinction between normally reflective tissueand abnormally reflective tissue will suffice, though the quality of theresults may vary.

FIG. 6 is another MinIP image, again using a partial volume takenbetween the ILM and the RPE and containing hyperreflective andhyporeflective tissue in the ONL. An area of hyperreflectivity is foundwithin the circle 610. This region is determined to be hyperreflectivebecause the average intensity within the region 610 is significantlyhigher than the average intensity of a normal region 630. An area ofhyporeflectivity is found within the circle 620. This region isdetermined to be hyporeflective because the average intensity within theregion 620 is significantly lower than the average intensity of a normalregion 630. Any statistic which provides a statistically meaningfuldistinction between normally reflective tissue and abnormally reflectivetissue will suffice, though the quality of the results may vary.

FIG. 7 illustrates an OCT device which can be used to implement thesubject invention. Further information about this type of OCT device isdisclosed in U.S. Patent Publication No. 2007/0291277, incorporatedherein by reference. A low coherence light source 700, typically asuperluminescent diode (SLD), is coupled to source fiber 705 that routeslight to directional coupler 710. The optimal directional strength ofthe coupling depends on system design choices and may be 90/10 (as shownin FIG. 7) or 70/30 or other choices depending on SLD back reflectiontolerance, the source illumination required to image the sample andother system design parameters. Directional coupler 710 splits the lightinto sample fiber 715 and reference fiber 735. The sample path mayinclude a delay apparatus (not shown) to adjust the length of the samplepath. The transverse scanner 720 deflects the OCT beam and preferablycreates a focus in the beam near the region of interest in sample 730.The transverse scanner laterally scans the optical beam across thesample in order to image a volume of the sample.

Some light scattered from sample 730 returns through the scanner anddelay apparatus to sample fiber 715. Coupler 710 routes this lightthrough loop 760 to fiber coupler 750, where it interferes with thereference light. The combining coupler 750 provides two outputs. Theseoutputs can be used for balanced detection (see U.S. Pat. No. 5,321,501,FIG. 10). Alternatively, the coupling ratio of coupler 750 can beadjusted to send most of the interfered light to a single OCT detector770. Each OCT detector can be a single photodetector for use intime-domain OCT or swept-source OCT, or a spectrometer for use inspectral domain OCT.

Optional tap 740 diverts a fraction of the reference light to detector745, which may be used to monitor the source power. Monitoring may beincluded to monitor the safety of the sample or to detect a degradationin the source 700. Alternatively, monitoring may not be included at allin the system. The tap removes some fraction of optical power from thereference fiber 735, reducing the power that reaches coupler 750.Sensitivity in OCT can reach the shot-noise limit if the reference poweris large enough to bring the interference signal above receiver noise,but not so large as to bring intensity noise or beat noise above thelevel of shot noise.

The coupling ratios in directional couplers 710, 740 and 750 are chosento set a safe level of illumination to the sample, and to set theappropriate reference power at the detector or detectors. For example,in the case of ophthalmic OCT of the retina using light with wavelengthsnear 850 nm, the safe exposure level is approximately 0.5 mW, and theoptimum reference level at the detector is approximately 0.005 mW.Sources are available in this wavelength range having output power ofapproximately 5 mW. For these conditions one would use a coupling rationear 90%/10% in the splitting coupler 710 so that 10% of the sourcepower reaches the sample. 90% of the backscattered light will then berouted to loop 760. In the case where there is a single OCT detector770, the combining coupler 750 preferably routes most of the samplelight to that detector. The splitting coupler 710 routes 90% of sourcelight, 4.5 mW, to reference fiber 735, while only 0.005 mW is requiredat the detector. One could use a combining coupler 750 that couples 0.1%of the reference light into the single OCT detector 770, but inmanufacture it is difficult to control the 0.1% coupling factor. Apreferred solution is to use a 99%/1% split ratio in combining coupler750, and take advantage of the additional degree of freedom in tap 740to adjust the reference power. Nominally, tapping 89% of the power formreference fiber 735 will provide an appropriate reference level of 0.005mW at OCT detector 770, in this example.

As an alternative to adjusting the tap ratio of optional tap 740, onecan adjust the reference level by including attenuating fiber (U.S. Pat.No. 5,633,974) in the reference path.

The output of the detector 770 is routed to processor 780. Thisprocessor may be a single device or a plurality of devices,preferentially optimized for their portion of processing. The processor780 is connected to one or more peripherals providing a user interfacedevices, such as display 790. The processor might also be connected toother user interface devices (such as a keyboard, mouse, joystick, andothers), and one or more external communication devices (such as a USBor network connector, optical storage media, printer, internet, andothers), as well as possibly connecting to other imaging hardware (suchas cameras, fixation targets, fundus viewers, and others) or peripheralpatient devices (such as head support, height adjustment, and others)which are not shown. The processor 780 provides the computational power(in one or more modules) processing functions such as image formation,volume rendering, segmentation, registration, evaluation of costfunctions, and/or other computational tasks required for medical imagingand analysis. Processed results may be displayed on display 790 orstored locally on a local storage device (not shown) or stored ordisplayed externally using one or more of the processor's externalcommunication devices.

It should be understood that the embodiments, examples and descriptionshave been chosen and described in order to illustrate the principles ofthe invention and its practical applications and is not intended to beexhaustive or to limit the invention to the precise form disclosed.Modifications and variations of the invention will be apparent to thoseskilled in the art in light of the above teaching. For example, whileextrema are described herein as minimums, under an alternative metric,the invention can be performed using maximums. The embodiments werechosen and described to explain the principles of the invention and itspractical application to enable others skilled in the art to best usethe invention in various embodiments and with various modificationssuited to the particular use contemplated. The scope of the invention isdefined by the claims, which include known equivalents and unforeseeableequivalents at the time of filing of this application.

The following references are hereby incorporated herein by reference.

U.S. Patent Documents

-   U.S. Pat. No. 5,189,369 Takane et al., NMR imaging method of low    flow rate fluid-   U.S. Pat. No. 5,321,501 Swanson, et al., Method and apparatus for    optical imaging with means for controlling the longitudinal range of    the sample-   U.S. Pat. No. 5,779,641 Hatfield, et al., Method and apparatus for    three-dimensional ultrasound imaging by projecting filtered pixel    data-   U.S. Pat. No. 6,436,049 Kamiyama et al., Three-dimensional    ultrasound diagnosis based on contrast echo technique-   U.S. Pat. No. 6,501,272 Haacke, et al. Application-specific    optimization of echo time in MR pulse sequences for investigating    materials with susceptibilities different from that of the    background in which they are embedded-   U.S. Pat. No. 6,505,064 Liu et al., Diagnostic imaging systems and    methods employing temporally resolved intensity tracing-   U.S. Pat. No. 6,658,280 Haacke; E. Mark, Susceptibility weighted    imaging-   U.S. Pat. No. 7,301,644 by Knighton et al., Enhanced optical    coherence tomography for anatomical mapping-   U.S. Pat. No. 2008/0100612 Dastmalchi; Shahram Shawn et al., User    interface for efficiently displaying relevant OCT imaging data-   U.S. Pat. No. 2007/0291277 Everett; Matthew J.; et al., Spectral    domain optical coherence tomography system

Other Publications

-   Leitgeb, R. A., et al. (2003). “Performance of Fourier domain vs.    time domain optical coherence tomography.” Optics Express 11(8):    889-894.-   Häusler, G. and M. W. Lindner (1998). ““Coherence Radar” and    “Spectral Radar”—New Tools for Dermatological Diagnosis.” Journal of    Biomedical Optics 3(1): 21-31.-   Napel S, Rubin G D, Jeffrey R B Jr., “STS-MIP: a new reconstruction    technique for CT of the chest”, J. Comput Assist Tomogr    1993;17:832-838.-   Narayana D L V Rao, Manpreet Singh Gulati, Shashi Bala Paul, Girish    Kumar Pande, Peush Sahni and Tushar Kanti Chattopadhyay,    “Three-dimensional helical computed tomography cholangiography with    minimum intensity projection in gallbladder carcinoma patients with    obstructive jaundice: Comparison with magnetic resonance    cholangiography and percutaneous transhepatic cholangiography”,    Journal of Gastroenterology and Hepatology, Volume 20, Issue 2,    Pages 304-308, 19 Jan. 2005.-   A. Salles, M. Nino-Murcia, R. Jeffrey, “CT of pancreas: minimum    intensity projections”, Abdominal Imaging, Volume 33, Number 2,    March 2008 , pp. 207-213(7).

What is claimed is:
 1. A method of generating an image of an anatomicalregion within an eye, said eye being examined by an optical coherencetomography (OCT) system, said OCT system including a light source forgenerating a beam of light, a sample arm, a reference arm, and adetector for measuring light combined from the sample and referencearms, said method comprising the steps of: a. scanning the beam of lightover a region of the eye via the sample arm; b. combining the light fromthe sample and reference arms; c. measuring the combined light; d.generating three dimensional volume image data of the eye from thecombined light; e. identifying a first surface within the image data; f.identifying a subvolume of the image data, said subvolume having lessthan all the generated image data, said subvolume being identified basedupon the identification of the first surface, said subvolume beingeither bounded by or including the first surface, said subvolumeincluding the anatomical region; g. selecting a set of image pointswithin the subvolume, said image points being selected by evaluating aplurality of ray projections extending through the subvolume andidentifying one image point in each projection, wherein each of theidentified image points has a common intensity attribute; h. determininga smooth reference surface using the locations of the set of identifiedimage points; i. generating an image based on the smooth referencesurface; and j. storing or displaying the image.
 2. A method as recitedin claim 1, wherein the smooth reference surface is determined byfitting.
 3. A method as recited in claim 1, further comprising using theintensity of image pixels within the volume to determine intensities atthe locations on the smooth surface.
 4. A method as recited in claim 1,wherein the image is generated by integrating a certain margin above andbelow the smooth reference surface.
 5. A method of generating an imageof an anatomical region within an eye, said eye being examined by anoptical coherence tomography (OCT) system, said OCT system including alight source for generating a beam of light, a sample arm, a referencearm, and a detector for measuring light combined from the sample andreference arms, said method comprising the steps of: a. scanning thebeam of light over a region of the eye via the sample arm; b. combiningthe light from the sample and reference arms; c. measuring the combinedlight; d. generating three dimensional volume image data of the eye fromthe combined light; e. identifying a first surface within the imagedata; f. identifying a subvolume of the image data, said subvolumehaving less than all the generated image data, said subvolume beingidentified based upon the identification of the first surface, saidsubvolume being either bounded by or including the first surface, saidsubvolume including the anatomical region; g. selecting a set of imagepoints within the subvolume, said image points being selected byevaluating a plurality of ray projections extending through thesubvolume and identifying one image point in each projection, whereineach of the identified image points has a common intensity attribute; h.generating an image based on information associated with the selectedset of image points; and i. displaying the image.
 6. A method as recitedin claim 5, wherein the subvolume contains the outer nuclear layer (ONL)of the eye, wherein the common intensity attribute corresponds to theminimum intensity of the associated ray projections, and furthercomprising identifying regions of retinal disruptions based on theminimum intensity.
 7. A method as recited in claim 6, wherein theminimum intensity is used to identify areas at risk of future pathology.8. A method as recited in claim 5, wherein the image generation is basedon location information associated with each of the selected set ofimage points within the associated ray projection and wherein thegenerated image is a height map of the maximum intensity locationsrelative to a reference surface.
 9. A method as recited in claim 5,wherein the generated image is a height map of the common intensityattribute locations and the height is encoded by color or brightness.10. A method as recited in claim 5, wherein one or more of the rayprojections are along axes different from the propagation axis of thebeam.